Endothelial cell loss after phacoemulsification: Relation to preoperative and intraoperative parameters

Abstract

The location of corneoscleral incisions for phacoemulsification can be chosen according to the preoperative astigmatism without inducing additional adverse effects on the corneal endothelium. Shorter eyes have a significantly higher risk for greater endothelial cell loss.

Coupling of HRT II and AS-OCT to evaluate corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant

“…They did not perform regional specular microscopy in the area of the tube. In our study, we found a mean endothelial cell loss of approximatively 8% for the central and peripheral cornea during a 6-month period after surgery, which is higher than the reported age-related endothelial cell loss, 15 but comparable or even less to that following cataract extraction 16,17 or other glaucoma filtering procedures. 6,7,18 Smith et al 6 calculated a mean central endothelial cell loss ranging from 1.6 to 54.8% three months after glaucoma surgery, correlated with postoperative AC depth and intraoperative corneal touch.…”

“…16,17,[20][21][22] However, the incision site, operative technique, and measurement methods vary and lead to different results. Recently, in a large series of 433 patients, Bourne et al 16 found a mean reduction in endothelial cell count of 16.1 and 14.2% 12 months following phacoemulsification and extracapsular cataract extraction, respectively.…”

Corneal endothelial function after phacoemulsification using the fluid-based system compared to conventional ultrasound technique

“…The results on mean ECL vary from 0.4 to 27.7% after phacoemulsification, depending on different surgical techniques. 2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In recent years, new surgical procedures have been developed to reduce ECL, such as laserand fluid-based methods. During the latter procedure, short pulses (4 ml) of warmed balanced salt solution liquefy the lens material, while the irrigation fluid surrounds the warmed pulsating fluid allowing cooling of the pulse.…”

Estudo do endotélio corneano em cirurgias de cataratas duras: extração extracapsular planejada da catarata e facoemulsificação

“…Com a modernização da facoemulsificação, a melhora tecnológica dos aparelhos, o emprego de agentes viscoelásticos, o surgimento de técnicas de fratura do núcleo dentro do saco capsular e o uso do ultra-som na câmara posterior, a perda endotelial baixou consideravelmente (7-12%) (14)(15)(16)(17) . Estudos que analisaram prospectivamente o dano endotelial ocorrido em cirurgias de cataratas não densas, comparando a EECC e a facoemulsificação, observaram perda endotelial similar com as técnicas (7-12% e 7-11%, respectivamente) (14)(15)(16) .…”

“…Neste aspecto, a facoemulsificação apresenta vantagens em relação à extração extracapsular convencional, por necessitar de menor incisão a indução de astigmatismo pós-operatório é menor (4,22) . A correlação positiva entre a perda endotelial e o tempo de ultra-som, utilizado nas cirurgias de facoemulsificação deste estudo, confirma os achados de outras pesquisas que apontam a energia ultra-sônica como um fator lesivo ao endotélio corneano (5,17) . Em um estudo prospectivo, com objetivo de identificar os principais fatores de risco para dano endotelial durante a facoemulsificação, avaliou-se a densidade endotelial no pré-operatório e com três meses de cirurgia, em 843 olhos.…”